| NPI | 1285400697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40043) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.034593) |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-11-27 |